207092 Proximal risk factors for chronic disease in Ontario, Canada: Challenges and opportunities of a comparative perspective

Tuesday, November 10, 2009: 11:00 AM

Norman Giesbrecht, PhD , Public Health and Regulatory Policy Section, Social, Prevention and Health Policy Research Department, Centre for Addiction and Mental Health, Toronto, ON, Canada
Hoi Ki Ding, MSc , Ontario Chronic Disease Prevention Alliance, Ontario Public Health Association, Toronto, ON, Canada
Jose J. Mangles, MAPA, MANPM , Prevention and Screening, Cancer Care Ontario, Toronto, ON, Canada
Danielle Paterson, MPA , Ontario Division, Canadian Cancer Society, Toronto, ON, Canada
Shawna Scale, MHSc , Ontario Chronic Disease Prevention Alliance, Ontario Public Health Association, Toronto, ON, Canada
Rebecca Truscott, MHSc, RD , Cancer Prevention and Screening Programs, Cancer Care Ontario, Toronto, ON, Canada
Connie Uetrecht, MSc, RD , Executive Director, Ontario Public Health Association, Toronto, ON, Canada
There is emerging literature on lessons from one risk factor to another: tobacco control experiences for reducing unhealthy diet, obesity, physical inactivity or high-risk drinking (Arora 2005/2006; Garcia 2008; Green et al. 2006; Musingarimi 2008; Warner 2005; Yach et al. 2005) or several risk factors (Ashe et al. 2003; Kersh & Moore 2002).

Goal: To summarize challenges and opportunities of translating lessons from Ontario's tobacco control to promoting healthy eating, weight management, active living and reducing high-risk alcohol consumption.

Methods: Analysis of published literature, government documents, NGO reports and professional experiences of the authors affiliated with the Canadian Cancer Society, Cancer Care Ontario, Centre for Addiction and Mental Health or the Ontario Public Health Association.

Results: A decline in tobacco use in Ontario was influenced by population level controls, community-based initiatives and smoking cessation measures; challenges remain in promoting further controls and reducing smoking. In contrast, overall consumption and high-risk alcohol use is increasing, and unhealthy eating is wide-spread in Ontario, as are physical inactivity and unhealthy weights. The multi-decade tobacco control experience in Ontario involved legislation, province-wide programs implemented by public health units and NGOs, and media campaigns. Promising initiatives focusing on alcohol, diet, physical activity and weight are currently uncoordinated, and no equivalent population-level strategies of sufficient scope and dose are evident.

Conclusion: A comprehensive approach and system-level perspective are required that include evidence-based interventions, advertising controls, community-based initiatives, regulation and economic approaches that have sufficient dose to reduce high-risk drinking, unhealthy diet, unhealthy weights and physical inactivity.

Learning Objectives:
1. Describe the information on research-based analysis of prevention lessons across several proximal risk factors for chronic disease. 2. List highlights of Ontario’s experience in tobacco control as a resource for planning more effective population-level and community-based interventions in alcohol management and reduction of unhealthy eating, unhealthy weights and physical inactivity. 3. Describe how this analysis has implications for other jurisdictions in North America interested in implementing comprehensive and system-level interventions to reduce proximal risk factors for chronic disease in their communities.

Keywords: Chronic Diseases, Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted research on chronic disease prevention and am currently a member of several organizations focusing on the prevention of chronic disease
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.